How much does Medicare pay for HCPCS G0102?

Medicare allowed an average of $22.66 per service and paid $13.08 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $55.75, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is HCPCS code G0102?

Prostate cancer screening; digital rectal examination. It was billed 5,486 times to 5,486 Medicare beneficiaries by 165 providers in 2024.

Does G0102 pay differently in an office than a hospital?

Yes. The allowed amount averaged $23.27 in an office setting and $8.70 in a facility. The office rate is generally higher because the practice supplies the room, staff and equipment out of that single payment; in a hospital those are billed separately by the facility.

Which specialty bills G0102 most?

Family Practice, with 2,636 services from 76 clinicians. Next are Internal Medicine, Gastroenterology, Diagnostic Radiology.

HCPCS G0102

Prostate cancer screening; digital rectal examination

$22.66Medicare-allowed amount per service, averaged across 5,486 services

Providers submitted

$55.75

Asking price, not received

Medicare allowed

$22.66

The fee schedule figure

Medicare paid

$13.08

Balance is patient coinsurance

Providers submitted an average of $55.75 for this code and Medicare allowed $22.66 — 2.5× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $13.08 (58%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $23.27
Hospital / facility: $8.70

The office rate is higher because the practice supplies the room, staff and equipment out of that payment. In a hospital the facility bills those separately, so the clinician's share is smaller — the total cost to Medicare is usually higher, not lower. 5,256 services were billed in an office setting and 230 in a facility.

Services: 5,486
Beneficiaries: 5,486
Providers billing it: 165
Total allowed: $124,313

What Medicare pays for HCPCS G0102

Across 5,486 services billed by 165 providers to 5,486 beneficiaries, Medicare allowed an average of $22.66 per service. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills G0102

Specialty	Services	Beneficiaries	Avg allowed	Providers
Family Practice	2,636	2,636	$22.65	76
Internal Medicine	2,234	2,234	$23.77	71
Gastroenterology	334	334	$18.03	6
Diagnostic Radiology	99	99	$24.36	1
Urology	95	95	$14.08	5
Nurse Practitioner	30	30	$18.94	2
Infectious Disease	19	19	$21.94	1
Nephrology	15	15	$26.33	1
General Surgery	12	12	$8.84	1
Emergency Medicine	12	12	$21.58	1

G0102 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

State	Services	Allowed	Standardized pmt	Providers
Texas	680	$20.17	$12.35	16
California	650	$25.92	$13.61	24
New York	562	$24.55	$14.22	15
Illinois	402	$24.07	$12.93	10
Michigan	322	$21.75	$13.37	7
Pennsylvania	313	$22.99	$12.03	9
Arizona	307	$22.53	$12.65	12
Massachusetts	296	$24.82	$12.60	13
Florida	239	$22.33	$12.32	6
New Jersey	220	$25.37	$13.71	6
Kansas	189	$21.24	$13.45	3
Virginia	170	$22.99	$13.64	3
Tennessee	159	$17.56	$11.23	4
South Carolina	155	$21.44	$12.93	2
Georgia	117	$22.62	$15.93	2
Washington	97	$26.27	$10.26	5
Ohio	91	$21.48	$13.32	3
North Carolina	90	$20.96	$12.09	5
New Hampshire	82	$8.60	$3.87	4
Nevada	79	$22.95	$14.09	4
Oregon	50	$22.18	$12.53	1
Iowa	47	$21.32	$13.74	1
Rhode Island	40	$23.75	$10.29	2
Connecticut	25	$24.75	$10.77	2
Nebraska	22	$8.35	$5.62	1
Missouri	22	$19.64	$15.91	1
Indiana	18	$8.15	$6.77	1
Mississippi	15	$19.51	$15.04	1
Kentucky	14	$19.96	$12.48	1
Colorado	13	$23.83	$11.22	1

Related codes

G0103Prostate cancer screening; prostate specific antigen test (psa)$18.89
G0127Trimming of dystrophic nails$17.81
G0180Physician or allowed practitioner certification for medicare-covered h$52.34
G0101Cervical or vaginal cancer screening; pelvic and clinical breast exami$37.86
G0181Physician or allowed practitioner supervision of a patient receiving m$103.01
G0179Physician or allowed practitioner re-certification for medicare-covere$40.20
G0105Colorectal cancer screening; colonoscopy on individual at high risk$287.76
G0145Screening cytopathology$25.95
G0121Colorectal cancer screening; colonoscopy on individual not meeting cri$295.44
G0136Administration of a standardized$16.63
G0108Diabetes outpatient self-management training services$53.63
G0123Screening cytopathology$19.83

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.